scholarly journals THE STRUCTURE OF THYROID NODULES IN CHILDREN SUBJECTED TO SURGICAL TREATMENT

2019 ◽  
Vol 21 (1) ◽  
pp. 63-66
Author(s):  
A V Gostimskii ◽  
Y L Skorodok ◽  
A A Taraikovich ◽  
S S Peredereev
Keyword(s):  
Thyroid Cancer ◽  
Surgical Treatment ◽  
High Risk ◽  
Thyroid Gland ◽  
Thyroid Nodules ◽  
Age Groups ◽  
Case Histories ◽  
Surgical Interventions ◽  
High Incidence ◽  
Surgical Tactics

The article provides the literary information and the results of our own research on the structure of the thyroid nodules in operated children.The clinical significance of nodular neoplasms of the thyroid gland is determined by the relatively high risk of carcinomas. Along with this, the relevance of this research is due to the increasing of surgical interventions and the fact that the features of nodules in children and tactics of management of patients remain debatable.The aim of the work was to study the structure of thyroid nodules in childrenin various age groups. The case histories of 225 operated childrenfrom 4 to 17 years oldfrom 2007 to 2017 were analyzed. Nodular neoplasms of the thyroid in children were more common. Tumor-like diseases - colloid nodes in childhood were rare, only in 2.2% of cases. The high incidence of thyroid cancer (35.6%) under the mask of nodal goiter determines active surgical tactics in patients with nodal neoplasms in childhood.

scholarly journals Chronic lymphocytic thyroiditis (CLT) has a negative prognostic value in papillary thyroid cancer of the young and middle ages: a retrospective analysis of 635 patients

2020 ◽  
Author(s):  
Bing'e Ma ◽  
Xiyi Chen ◽  
Zhengping Zhao ◽  
Qin Ji ◽  
Yifan Zhou ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
High Risk ◽  
Prognostic Value ◽  
Age Groups ◽  
Recurrence Risk ◽  
Lesion Size ◽  
Chronic Lymphocytic Thyroiditis ◽  
Papillary Thyroid ◽  
Lymphocytic Thyroiditis ◽  
Risk Recurrence

Abstract Background: The study was aimed at investigating the potential role of chronic lymphocytic thyroiditis (CLT) in papillary thyroid cancer (PTC) prognosis in distinct age groups, as well as the association between CLT and recurrence risk estimation.Methods: A total of 635 adult patients were retrospectively analyzed. On the basis of postoperative pathology examination, 188 patients were diagnosed with coexistent CLT and the remaining 447 were classified as non-CLT. Then the characteristics of CLT-coexisted patients and non-CLT ones were compared respectively when patients were aged ≥55 years or below. The association among postoperative clinicopathological features were also analyzed using multivariate regression. In addition, the prognostic value of several variables relating to high-risk recurrence were estimated within different age groups.Results: When divided in two age groups (55 years as the line), non-CLT group had a remarkable frequency of small size lesion (D max ≤1cm) compared with CLT-coexisted patients (54.6% to 43.0%, p =0.016). In addition, non-CLT patients tended to have intrathyroidal extension as opposed to those with coexistent CLT (20.2% to 28.2%, p =0.05). In multivariate analysis, CLT still significantly acted as an independent risk factor of greater lesion size (D min >1 cm) (OR=1.7, p =0.02) and mildly promoted gross extrathyroidal extension (ETE) (OR=1.4, p =0.06). However, associations didn't emerge in the characteristics mentioned above with CLT when patients were ≥55 years old. The prognostic value of CLT in high-risk recurrence was evident only in patients aged 35-44 years. (OR=2.4, 95%CI:1.2-5.4, p =0.02). Greater lesion size independently promoted gross ETE, no matter patients were aged above 55 years or not. Besides, its prognostic value of high-risk recurrence was significant throughout all age groups. Conclusion: These findings revealed that CLT coexistence might be the unfavorable factor of PTC prognosis in young and middle-aged (<55 years) patients, and its role in recurrence risk stratification was presented only in the specific age (35-44 years).

scholarly journals FEATURES OF SURGICAL APPROACHES TO THE DIAGNOSIS AND TREATMENT OF THYROID DISEASES IN PATIENTS OF OLDER AGE GROUPS

2020 ◽  
Vol 75 (3) ◽  
pp. 26-33
Author(s):  
Yu.V. Kukhtenko ◽  
◽  
L.A. Ryaskov ◽  
O.A. Kosivtcov ◽  
I.V. Mikhin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Thyroid Gland ◽  
Clinical Characteristics ◽  
Age Groups ◽  
Older Age ◽  
Surgical Approaches ◽  
Topical Issue ◽  
Thyroid Pathology ◽  
High Comorbidity ◽  
Surgery In Elderly

Diagnostics, tactics of medical and surgical treatment of various diseases of the thyroid gland is a topical issue in patients of older age groups. The peculiarity of this category of patients is high comorbidity, so the volume of surgery should be determined not only by the type and severity of the course of thyroid pathology, but also by the clinical characteristics of concomitant diseases. To date, the issue of choosing the volume of surgery in elderly and senile patients remains debatable.

scholarly journals Choice of tactics of surgical treatment of acute cholecystitis and its complications

2018 ◽  
Vol 22 (3) ◽  
pp. 442-445
Author(s):  
B.S. Zaporozhchenko ◽  
K.V. Kravets ◽  
I.E. Borodaev ◽  
D.A. Bondarets ◽  
D.A. Bondarets ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Average Duration ◽  
Abdominal Cavity ◽  
Age Groups ◽  
Total Duration ◽  
Duration Of Treatment ◽  
Surgical Interventions ◽  
Emergency Operations ◽  
Surgical Tactics

Acute cholecystitis ranks second in the incidence of urgent surgical diseases in hospitals in Ukraine. Despite a marked improvement in the treatment results, the lethality after emergency operations (9,4-37%) for acute cholecystitis complicated by peritonitis remains several times higher than with routine surgical interventions. Objectives — development of rational surgical tactics and evaluation of the effectiveness of treatment of acute cholecystitis and its complications in patients of different age groups, with different pathomorphological forms of acute cholecystitis. The result of treatment of 203 patients was presented: 75 (37,5%) were operated on an emergency basis, 73 (36,5%) urgently, and 52 (26%) in a deferred period. 173 (86.5%) patients were operated using laparoscopic technologies. Intraoperative cholangiography was performed in 16 (9,3%) patients during laparoscopic interventions. In 17 (8,5%) patients, “open” operations were performed. All patients underwent drainage of the abdominal cavity with one or more drains in view of the presence of peritonitis. The average duration of the preoperative period was 1.5 days, the total duration of treatment with LC was 4.5 days, and the total duration of treatment with OC was 10.8 days. So, in the early stages of the development of acute cholecystitis, laparoscopic cholecystectomy is effective. The use of lifting systems for laparoscopic cholecystectomy is advisable in elderly and senile patients, with concomitant diseases of the heart and lungs.

scholarly journals SURGICAL TREATMENT OF HIGH-RISK PATIENTS IN PATIENTS

2019 ◽  
pp. 6-11
Author(s):  
V. V. Boyko ◽  
Yu. V. Ivanova ◽  
M. E. Tymchtnko
Keyword(s):  
Surgical Treatment ◽  
High Risk ◽  
Postoperative Morbidity ◽  
Morbidity And Mortality ◽  
High Risk Patients ◽  
Risk Patients ◽  
Surgical Tactics ◽  
Level Of Risk

Summary. Due to analysis of the factors that lead to incompetence of bowels` anastomosis and sutures the levels of risk of the development of this complication were created. The surgical tactics depending on the level of risk of the development of bowels` sutures and anastomosis incompetence was created. The method of forming of late bowels` anstomosis in patients with high and moderate levels of risk of  the development of bowels` sutures and anastomosis incompetence were created. This method excludes performing of multistaged  intraabdominal operations. The using of developed algorithm allows to decrease postoperative morbidity and mortality.

scholarly journals A SURGICAL TACTICS IN THE INJURY OF TRACHEA AND BRONCHI IN CHILDREN

2020 ◽  
Vol 23 (6) ◽  
pp. 351-354
Author(s):  
Viacheslav I. Ponomarev ◽  
A. V. Pisklakov ◽  
A. V. Lysov ◽  
V. V. Vysotsky
Keyword(s):  
Surgical Treatment ◽  
Incidence Structure ◽  
Early Period ◽  
Early Postoperative Period ◽  
Long Term Results ◽  
Airway Patency ◽  
Surgical Interventions ◽  
Ventilation Failure ◽  
Surgical Tactics ◽  
Trachea And Bronchi

Introduction. Tracheal and bronchial injuries in children are not at the last place in the trauma incidence structure . It is an urgent issue for both adult and pediatric surgeons. Purpose. To show ways for obtaining good outcomes in patients with trachea and bronchi rupture. Material and methods. The researchers analyzed outcomes of surgical treatment of 19 patients with trachea and bronchi ruptures. The patients had surgeries at various intervals after the injury: from few hours to 10 days. X-ray and tracheobronchoscopy examinations were made. On the first day after the injury, a radical surgery was performed to restore the airway patency. Late surgical interventions ended with pulmonectomy or lobectomy. At the final stage of the trial, early and long-term results were analyzed. Results. The radical surgical treatment consisting of thoracotomy and complete restoration of anatomical integrity and airway patency had 16 children of various age on the first day after their injury . Surgery lasted for 85 ± 15 min. There were no any complications during the surgery. At the early period of observation after the surgery, a ventilation failure of degree I was seen in 3 patients. Two years later, compensated stenosis of the bronchus without signs of ventilation failure was seen in one child. Three children were operated on in 10 days after their injury. Organ-sparing surgeries were performed in them (lobectomy and pulmonectomy). These surgeries lasted for 130 ± 15 min. At the early postoperative period, all three patients had ventilation failure of degree II. In 2 years, two children developed a persistent deformation of the chest, two children were disabled. Conclusion. A successful treatment of children with lower airways injury may be expected if the radical assistance is provided by a thoracic surgeon and shortly after the injury.

scholarly journals Morbidity and prevalence of the genitourinary system diseases in children in the Udmurt Republic

2012 ◽  
Vol 93 (3) ◽  
pp. 526-529
Author(s):  
T N Strelkova
Keyword(s):  
Health Care ◽  
Detection Rate ◽  
Age Groups ◽  
Hereditary Diseases ◽  
Urinary System ◽  
Case Histories ◽  
Ministry Of Health ◽  
Genitourinary System ◽  
High Incidence ◽  
Udmurt Republic

Aim. To identify the pattern of distribution of nephropathy in a limited population (living in the same area) with the same risk factors ratio for the development of this disease. Methods. Conducted was an analysis of annual statistical reports of the nephrological morbidity in the Udmurt Republic, covering 306,355 children. Calculated were the intensive parameters that characterize the incidence among child population, using the method of calculating the relative magnitudes of clarity. Presented was a retrospective analysis of 8379 case histories of children admitted to the Children’s Nephrology Department of the Budget Institution of the Ministry of Health Care of the «Republican Children’s Clinical Hospital of the Ministry of Health care of the Udmurt Republic» with diseases of the urinary system. Results. Revealed was a high incidence of urinary tract pathology in children of all age groups with a tendency for increase in both the general and primary morbidity, regardless of the place of residence. Stated was an increase in the detection rate of chronic renal failure in early childhood, which in 86.1% of cases developed secondary to congenital and hereditary diseases of the urinary system. Conclusion. The obtained data should be considered when planning the children’s nephrology urology services of the Udmurt Republic.

scholarly journals REHABILITATION OF PATIENTS AFTER OPERATIONS ON THE THYROID

2019 ◽  
Vol 21 (1) ◽  
pp. 91-94
Author(s):  
S N Pamputis ◽  
Yu K Aleksandrov ◽  
A D Dyakiv ◽  
I E Belyakov
Keyword(s):  
Surgical Treatment ◽  
Thyroid Gland ◽  
Skin Incision ◽  
Comprehensive Treatment ◽  
Surgical Interventions ◽  
Recurrent Goiter ◽  
Original Scheme ◽  
Upper Mediastinum ◽  
Preoperative Examination

Scientists and specialists, who works in the field of treatment thyroid gland diseases, identify and eliminate the effects of surgical interventions with nodular, multinodular and recurrent goiter with symptoms of compression of the organs of the neck and upper mediastinum. In total, the study included 119 patients who underwent extirpation of the thyroid gland (43), resection of the thyroid gland (33) and hemithyroidectomy (43). Comparisons were made on the basis of the volume of the preoperative examination, the immediate surgical intervention and the features of the intraoperative technique. It was established that the severity of local pain, postoperative complications such as neck edema during hematoma and gray formation reliably depended on the size of the skin incision, dissection of the short neck muscles, mobilization of the nodding muscles and removal of the tissue from the lymph nodes. 6 months after the surgical treatment, the patients had no complaints. If hypocalcemia occurs (in 14 cases), patients undergo a comprehensive treatment according to the original scheme. As a result of the treatment in all cases, the action of hypocalcemia was stopped. The study shows that the effectiveness of surgical treatment, the postoperative period, complications, cosmetic results and quality of life, as well as rehabilitation studies aimed at reducing the effectiveness of preoperative examination, increasing the amount of operational benefits and late statement of complications.

scholarly journals Carbuncle - the actual problem of modern surgery (Literature review)

2019 ◽  
Vol 21 (4) ◽  
pp. 19-24
Author(s):  
K V Lipatov ◽  
Yu E Cherkasov ◽  
V I Khrupkin ◽  
M V Lysenko ◽  
E I Dekhissi
Keyword(s):  
Surgical Treatment ◽  
Literature Review ◽  
Plastic Surgery ◽  
Pathological Process ◽  
Tissue Viability ◽  
Actual Problem ◽  
Surgical Interventions ◽  
Timely Diagnosis ◽  
Results Of Treatment ◽  
Surgical Tactics

Analyzed the features of the surgical treatment of carbuncles. The severity of the purulent-necrotic process was assessed, the significance of the timely diagnosis of the inflammatory stage and the choice of the timing of surgical treatment is shown. The features of the options of surgical tactics - from gentle to radical surgical interventions, methods of intraoperative assessment of tissue viability in the inflammatory focus are described. The necessity of a differentiated approach to the treatment of carbuncles depending on the stage of the disease, the prevalence of the pathological process and its localization is substantiated. The significance of restorative skin-plastic surgery in the replacement of postnecrectomy defects of epithelial tissues in the treatment of extensive carbuncles is shown. Ways of improving the results of treatment of patients with carbuncles are outlined, including timely diagnosis, a differentiated approach to surgical treatment, rational antibacterial therapy, and adequate general treatment.

scholarly journals Surgical treatment of patients with descending purulent mediastinitis

2021 ◽  
Vol 26 (4) ◽  
pp. 118-123
Author(s):  
I.M. Shevchuk ◽  
S.S. Snizhko
Keyword(s):  
Surgical Treatment ◽  
Pleural Cavity ◽  
Comparison Group ◽  
Postoperative Mortality ◽  
Complete Removal ◽  
Main Group ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Minimally Invasive Surgical ◽  
Surgical Tactics

The aim of the study was to improve the results of treatment of patients with descending purulent mediastinitis by means of individualized surgical tactics with the priority use of minimally invasive surgical interventions and developed methods of drainage of the mediastinum and pleural cavity. Examination and treatment of 73 patients with descending purulent mediastinitis receiving treatment in the department of thoracic surgery of Ivano-Frankivsk regional clinical hospital was carried out. Treatment of patients in the main group included intramediastinal administration of antibiotics, the use of the developed method of cascade drainage of the mediastinum and pleural cavity, the priority use of video-assisted thoracoscopy and surgical tactics aimed at anticipating the spread of the purulent process in the mediastinum. The rapid and reliable decrease in the indices of endogenous intoxication in the main group confirms the effectiveness of the developed tactics of surgical treatment of patients with mediastinitis, adequate sanation of purulent mediastinatis, complete removal of the purulent substrate from the mediastinum and pleural cavity. The developed tactics of surgical treatment of purulent mediastinitis allowed reducing the overall postoperative mortality from 26.3% in the comparison group to 11.4% in the main group of patients.

The significance of primary monocanalicular silicone tube intubation in late surgical treatment in children

2021 ◽  
pp. 112067212110206
Author(s):  
Berna Sahan ◽  
Ferda Ciftci
Keyword(s):  
Surgical Treatment ◽  
Treatment Success ◽  
Age Groups ◽  
Silicone Tube ◽  
Significant Treatment ◽  
Surgical Interventions ◽  
Patient Complaints ◽  
Silicone Tube Intubation ◽  
Time Test ◽  
The Difference

Purpose: To evaluate the effect of monocanalicular silicone tube intubation outcomes as an initial surgical treatment in children older than 1 year old with primary nasolacrimal obstruction. Methods: Probing or monocanalicular silicone tube intubation was performed as primary surgical treatment on 12–48 months old children with primary nasolacrimal obstruction. Probing was performed on 53 eyes of 43 patients and silicone tube intubation on 45 eyes of 39 patients. Treatment was considered successful after improvement in patient complaints, the presence of normal tear meniscus, and normal results of fluorescein disappearance time test. Retrospective treatment success was compared between two groups according to age groups. Results: Treatment success was 79.1% in the probing group and 92.3% in the silicone tube intubation group. The success of the treatment was evaluated separately in the groups of 12 to <24 months, 24 to <36 months, and 36 to <48 months, and although the success level of the silicone tube intubation group was consistently found to be higher, the difference was not statistically significant. Treatment success decreased statistically significantly in the probing group with increased age of the patients, especially after 24 months. There was no such statistically significant decrease in the silicone tube intubation group. Conclusion: The choice of monocanalicular silicone tube intubation for primary surgical treatment in children with primary nasolacrimal obstruction provides success without the need for repetitive surgical interventions, especially in children older than 24 months.

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